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Frailty as a predictor of mortality in older adults within 5 years of psychiatric admission

Benraad, C. E. M., Haaksma, M. L., Karlietis, M. H. J., Voshaar, R. C. O., Spijker, J., Melis, R. J. F. & Rikkert, M. G. M. O., 23-Feb-2020, In : International Journal of Geriatric Psychiatry. 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Carolien E. M. Benraad
  • Miriam L. Haaksma
  • Mieke H. J. Karlietis
  • Richard C. Oude Voshaar
  • Jan Spijker
  • Rene J. F. Melis
  • Marcel G. M. Olde Rikkert

Objectives Older adults with psychiatric disorders have a substantially lower life expectancy than age-matched controls. Knowledge of risk factors may lead to targeting treatment and interventions to reduce this gap in life expectancy. In this study, we investigated whether frailty independently predicts mortality in older patients following an acute admission to a geriatric psychiatry hospital.

Methods Clinical cohort study with a 5-year follow-up of 120 older patients admitted to a psychiatric hospital between February 2009 and September 2010. On admission, we assessed frailty with a frailty index (FI). We applied Cox regression analyses with time to death as the dependent variable, to examine whether the FI was a predictor for mortality, adjusted for age, sex, level of education, multimorbidity (Cumulative Illness Rating Scale for Geriatrics, CIRS-G scores), functional status (Barthel Index), neuropsychiatric symptoms (NPS), and severity of psychiatric symptoms at admission (Clinical Global Impressions Scale of Severity).

Results Of the 120 patients, 63 (53%) patients were frail (FI >= 0.25), and 59 (49%) had died within 5 years. The FI predicted mortality with a hazard ratio (HR) of 1.78 (95% CI, 1.06-2.98) per 0.1 point increase, independent of the covariates. Co-morbidity measured by the CIRS-G and functional status measured by the Barthel Index were not significantly associated.

Conclusions Frailty was a strong predictor of mortality, independent of age, gender, multimorbidity, and functional status. This implies that frailty may be helpful in targeting inpatient psychiatric treatment and aftercare according to patients' life expectancy.

Original languageEnglish
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Early online date3-Feb-2020
Publication statusPublished - 23-Feb-2020

    Keywords

  • frailty, index, functional status, geriatric psychiatry, hand grip strength, mortality, multimorbidity, nutritional status, severe psychiatric disorders, walking speed, MINI NUTRITIONAL ASSESSMENT, FUNCTIONAL DECLINE, GRIP STRENGTH, MULTIMORBIDITY, OUTCOMES, EPIDEMIOLOGY, DISABILITY, FITNESS, HEALTH, INDEX

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